Microbial eczema of the feet

Twenty-seven patients were investigated for eczema of the feet which mainly affected the medial interdigital spaces and the dorsal areas of the medial toes. The lesions tended to spread to the dorsum of the foot, rather than the plantar surface as seen in tinea pedis, which typically affects the lateral interdigital spaces. In all patients S. aureus and/or haemolytic streptococci were cultured, whereas scrapings for fungi were negative. All responded well to treatment aimed at eradicating bacteria and dermatitis, but relapses occurred in 33% of the cases. We believe this clinical entity is due to infective dermatitis in which the presence of bacteria provokes an eczematous response in the host, probably due to pre-existing sensitization rather than direct infection.